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Rapid and Deferred Help Seeking Among African American Parents of Children With Emotional and Behavioral Difficulties
Jennifer Richmond1, Leslie B Adams1, Izabela E Annis1
1Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee (Richmond); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Adams); Division of Pharmaceutical Outcomes and Policy, University of North Carolina Eshelman School of Pharmacy, Chapel Hill (Annis, Thomas); School of Social Work, North Carolina State University, Raleigh (Ellis); Department of Counseling, Higher Education, and Speech-Language Pathology, University of West Georgia, Carrollton (Perryman); Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina (Sikich).
Insights
African American parents
Area of Science:
- Child Psychology
- Mental Health Services Research
- Health Disparities
Background:
- Limited understanding exists regarding factors influencing African American parents' decisions to seek care for children's emotional and behavioral difficulties.
- Identifying timely care-seeking patterns is crucial for addressing mental health needs in this population.
Purpose of the Study:
- To investigate factors associated with rapid care seeking (within 30 days) versus delayed care seeking (≥1 year) among African American parents.
- To explore the roles of parent activation, medical mistrust, and care-seeking barriers in these decisions.
Main Methods:
- Cross-sectional survey of 289 African American parents of children with emotional or developmental challenges.
- Logistic regression analysis to identify predictors of rapid and delayed care seeking.
Main Results:
- Approximately 22% of parents sought care rapidly, while 49% deferred care for a year or more.
- Higher parent activation and medical mistrust were associated with rapid care seeking.
- Fear of involuntary hospitalization and insurance coverage issues were significant barriers to timely care.
Conclusions:
- Findings highlight the complex interplay of individual, systemic, and cultural factors influencing care-seeking behaviors.
- Interventions should address facilitators and barriers to mental health care for African American families.
- Community-based professionals need to be aware of these factors to support families effectively.
Objective:
Little is known about the factors African American parents consider when seeking care for their child after emotional and behavioral difficulties emerge. This study aimed to examine factors associated with seeking professional care within 30 days after identifying a child's need (i.e., rapid care seeking) and with deferring care for ≥1 year.
Methods:
This cross-sectional study surveyed African American parents raising a child with emotional or developmental challenges (N=289). Logistic regression was used to examine associations of parent activation, medical mistrust, and care-seeking barriers with two outcomes: rapidly seeking care and deferring care seeking.
Results:
About 22% of parents rapidly sought care, and 49% deferred care for 1 year or longer. Parents were more likely to rapidly seek care if they had higher parent activation scores; lived with other adults with mental health challenges; or, contrary to the authors' hypothesis, mistrusted doctors. Parents were less likely to rapidly seek care if the challenge did not initially bother them much or if their health insurance would not cover the service. Parents were more likely to defer care if they feared involuntary hospitalization for their child or if their health insurance would not cover the service. Parents were less likely to defer care if they had at least some college education or lived with other adults with mental health challenges.
Conclusions:
Community-based pediatric and child welfare professionals should be informed about facilitators and barriers to mental health care seeking as part of efforts to develop interventions that support African American families.
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